Sure Start is an initiative in India that works to educate women and their communities about maternal and neonatal health. In one village in Uttar Pradesh, Sure Start engaged mothers, mothers-in-law, and fathers-to-be through group meetings using games and activities to spread awareness of safe childbirth practices. As a result, the village headman estimates that 70-75% of adults became aware of such practices, and community health facilities have improved. The goal of Sure Start is to transform passive communities into active agents of change around maternal and child health.

1. Title: Transforming passive onlookers to agents of change
Body:
Every year, tens of thousands of women and babies in India die due to complications of
pregnancy and delivery—most of them preventable. Despite the magnitude of the
problem, there is widespread lack of awareness and access to maternal and newborn child
care medical facilities across the country.
Such was the case in Bharkherva village in Uttar
Pradesh, India. The issue of maternal and child
health took a backseat to the other problems facing
the communityelectricity shortages, delayed
monsoons, ruined crops, and poverty. That is, until
Mr. Nirbhay Singh, the elected village headman,
was approached by Sure Start.
Sure Start—a five-year initiative based at PATH,
an international not-for-profit organization
supported by the Bill & Melinda Gates
Foundation—is working to help mothers and their
children to survive and stay healthy in the states of
Uttar Pradesh and Maharashtra.
In the numerous villages in Uttar
Pradesh where Sure Start works,
you will find a twist on the
contentious extended family
relationships depicted in most
Indian television serials. Here,
mothers-to-be and mothers-in-law
are both part of “mothers’ groups”
facilitated by Sure Start. Village women work together with the local health care provider
to organize meetings that tackle important topics with entertaining methods—dolls,
games, music, and dance are employed to bring about behavioral change. Since January
2008, Sure Start has organized 80,000 group meetings involving approximately
1,200,000 expectant mothers and their mothers-in-law.
Women are not the only ones learning about newborn care. As part of the program,
fathers-to-be receive letters from their unborn children. The letters help men understand

2. the importance of their role in ensuring a safe delivery for their wives and unborn
children.
The results are extremely encouraging. Mr. Singh estimates that since the program began
in his village in 2008, 70 to 75 percent of adults in the community have become aware of
safe delivery practices and the vital importance of ensuring access to maternal and child
health services.
Sure Start has also been instrumental in
working with many of the existent (but often
inactive) government-run Village and Health
Sanitation Committees and ensuring that
members hold regular meetings. This has led
to the improvement of facilities at the
primary health care level. “No longer do we
always need to travel all the way to the big
district hospital,” Mr. Singh says proudly.
The essence of Sure Start's endeavor is to transform communities from passive onlookers
to agents of change. “I do this in order to pay my debt to the country,” says one
community volunteer. “I understand that I can’t do big things, but I can at least bring
about tangible change in my neighborhood.”
Sure Start works to educate women in India on maternal and neonatal health. Sure Start, an
initiative by PATH, supported by the Bill & Melinda Gates Foundation works to promote safe
childbirth practices in India.
Facebook: http://www.facebook.com/pages/Sure-Start-Project-by-Path/178629192101
Twitter: http://twitter.com/pathsurestart